Marked Mydriasis and Neuritis Nervi Optici Associated with Galactorrhea Following Citalopram Treatment: A Case Report and Discussion

Horst J. Koch,Heike Zellmer

doi:10.1155/2011/191735

Abstract

We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. However, galactorrhea persisted for a few weeks necessitating treatment with bromocriptine.

Highlights

Anisocoria and mydriasis are neurological symptoms which necessitate immediate medical attention including neurological, ophthalmological, and neuroradiological diagnostics
We present the case of a 25-year-old women who developed a trias of marked mydriasis, neuritis nervi optici, and galactorrhea after treatment with citalopram
The patient presented is the first case in the literature suffering simultaneously from the trias of marked mydriasis, optic neuritis, and galactorrhea

Summary

Case Report

Marked Mydriasis and Neuritis Nervi Optici Associated with Galactorrhea Following Citalopram Treatment: A Case Report and Discussion. We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. Galactorrhea persisted for a few weeks necessitating treatment with bromocriptine

Introduction

Discussion and Conclusion